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PubMed2005

Predicting bacteriuria in urogynecology patients.

OBJECTIVE: This study was undertaken to determine whether reagent strip testing can predict bacteriuria in urogynecology patients. STUDY DESIGN: All women undergoing urodynamic evaluations from June 1997 to October 2001 were identified by using a computerized database. Urine culture results were compared with reagent strip testing. Significant bacteriuria was defined as greater than 10(5) colony-forming units per milliliter. RESULTS: Bacteriuria prevalence was 8.6% (n = 51). Sensitivity and specificity of nitrites were 0.51, (95% CI, 0.31-0.66) and 0.991, (95% CI, 0.974-0.998), respectively. Blood had a lower sensitivity (0.35, 95% CI, 0.20-0.54) and specificity (0.80, 95% CI, 0.75-0.84). Leukocyte esterase was similar to blood with a sensitivity of 0.28 (95% CI, 0.14-0.45) and specificity of 0.83 (95% CI, 0.78-0.87). No combination of tests offered improved sensitivity or specificity over nitrites alone. CONCLUSION: Nitrite dipstick testing has excellent specificity for bacteriuria in urogynecologic patients. These results support the treatment of women with positive nitrites who are preparing to undergo urodynamics without obtaining culture.

Adult↗
PubMed1997

Clinical evaluation of a leukocyte esterase test-strip for detection of feline pyuria.

Commercial macroscopic test-strips (dipsticks) that indirectly detect urine leukocytes by quantifying leukocyte esterase (LE) activity have been advocated as a simple, rapid, and inexpensive alternative to microscopic examination for detection of significant pyuria in urine specimens. The purpose of this study was to evaluate the diagnostic performance of a commercial LE test-strip for detection of feline pyuria. Two hundred and thirteen consecutive urine specimens were collected from 188 different feline patients and analyzed for LE activity with a LE test-strip (Multistix 2 Reagent Strips:Ames Division, Bayer Corp., Elkhart, IN). Results of the LE test-strip were compared with those of standard urine biochemical and microscopic sediment evaluations. Compared with urine sediment leukocyte counts, the LE test-strip had a sensitivity of 77%, a specificity of 34%, positive and negative predictive values of 14 and 91 % respectively, and an overall test efficiency of 39%. Multivariable logistic regression analysis did not reveal significant associations between pyuria (>5 WBC/hpf) and a positive LE test- strip reaction; however, hematuria, lipiduria, increasing age, and decreasing urine specific gravity were associated with a significantly increased risk for positive LE test-strip reactions. We conclude that the LE test-strip evaluated in this study is highly nonspecific for detection of significant pyuria in feline urine specimens and should not replace routine microscopic urine sediment examination in this species.

Journal Article↗
PubMed1997

Comparison of two methods of bedside blood glucose screening in the NICU: evaluation of accuracy and reliability.

Bedside whole blood glucose screening in the NICU has been an accepted method of care for several years. Meters or visually read reagent strips are used in bedside screening, but the reliability and accuracy of these methods are not always established before they are implemented as routine practice in the NICU. A study was conducted to determine which method of bedside whole blood glucose screening was the more accurate: visually read Chemstrip bG reagent strips or the One Touch II meter method. The values obtained were compared with lab analysis of serum glucose, and a correlation study was performed to compare the accuracy and reliability of the values produced by the two methods. One hundred samples were obtained from 38 NICU infants; 63 percent of the 100 samples were compared with lab values. Results revealed that the One Touch II method was more reliable (r = .92) than the Chemstrip bG method (r = .87). Furthermore, the One Touch II results correlated better with lab values when the meter was not operated in the neonatal mode. This study revealed that the One Touch II method appears to provide safe and accurate screening of bedside blood glucose in a high-risk neonatal population.

Blood Glucose↗
PubMed2006

Diagnosis of spontaneous bacterial peritonitis in cirrhotic patients in northeastern Brazil by use of rapid urine-screening test.

CONTEXT AND OBJECTIVE: Spontaneous bacterial peritonitis (SBP) is a frequent and severe complication of cirrhotic patients with ascites. It has been proposed that the reagent strip for leukocyte esterase designed for the testing of urine (Combur test UX) could be a useful tool for diagnosing SPB. The aim of this study was to assess the sensitivity and specificity of urine test strips for diagnosing SBP in cirrhotic patients with ascites. DESIGN AND SETTING: Prospective study, at a university hospital in northeastern Brazil. METHODS: Forty-two unselected consecutive cirrhotic patients (32 males; mean age: 51.7 +/- years) were included, and a total of 100 paracenteses were performed. All ascitic fluid samples were analyzed using the reagent strip and cytology, neutrophils, lymphocyte count, appropriate biochemical tests and culturing. The strips were considered positive if the color became purple on a colorimetric scale. RESULTS: Nine patients were diagnosed with SBP using cytology (> 250 neutrophils/mm(3)), and the strips were positive for all these nine patients with SBP. In one sample, the strip was positive but the neutrophil count was less than 250 cells/mm(3). For 86 samples, both the strips and cytology were negative. At the threshold of 250 neutrophils/mm(3) in ascitic fluid, the sensitivity, specificity, positive predictive value and negative predictive value for the strips were respectively 100%, 98.9%, 92.3% and 100%. CONCLUSION: The Combur test UX urine screening test is a very sensitive and specific method for diagnosing SBP in cirrhotic patients with ascites.

Ascites↗
PubMed1990

Validation of a method for the rapid diagnosis of urinary tract infection suitable for use in general practice.

A combination of reagent strip testing and examining urine appearance can be used to screen out noninfected cases before urine specimens are sent to the laboratory. A validation of this method was carried out in a microbiology laboratory using 970 specimens received over a three-week period. When the tests for nitrite, blood and protein on N-Multistix reagent strips (Ames) were all negative in a clear urine then the predictive value for the absence of bacteriuria was 98.5%. Positive strip tests in a turbid urine detected 80.1% of infections. On the basis of these findings it is recommended that general practitioners test the urine samples of all patients with suspected urinary tract infections by this method and only send to the laboratory those specimens with positive findings. Using this method the routine laboratory workload involved in testing urine specimens would be reduced by 40%, instant results would be available in the general practitioner's surgery and the patient would receive immediate and appropriate treatment.

Bacteriuria↗
PubMed1988

[Evaluation of a screening test for urinary infection].

The interest of using a reagent strip (Multistix-8 SG, Ames, Miles Laboratories) as a screen for urinary tract infection was evaluated in a clinical study involving several sites and 2,183 adult urine specimens of which 340 were infected. The results are expressed in terms of sensitivity, specificity, predictive value of a negative and positive test. The predictive value of a negative test for nitrites in combination with leucocytes (97.5%) justifies the use of the reagent strip in eliminating non-infected urine.

Bacteriological Techniques↗
PubMed1986

Prevalence of hematuria in urothelial neoplasia.

Voided urine specimens from 82 cases of histologically verified urothelial neoplasia (transitional cell carcinoma grades I, II, III, and carcinoma in situ [CIS] ) were evaluated for the presence of gross and microhematuria (MH). Microhematuria was assessed macroscopically with the reagent-strip blood test and evaluated microscopically with enumeration of erythrocytes using a standardized semiquantitative Papanicolaou-stained urine sediment examination. The authors' retrospective study indicated that gross hematuria rarely was present in urothelial neoplasia, however, occult blood (greater than 5 RBC/HPF) was present in four out of five cases when one sample was examined. In some cases there was an overlap between the number of erythrocytes excreted by control population and those with urothelial neoplasms. Urine sediment examination was more sensitive than reagent-strip testing for MH in patients with urothelial neoplasia.

Adult↗
PubMed2004

[Modelling sensitivity, specificity and predictive values of hematuria testing using reagent sticks in the diagnosis of Schistosoma haematobium infection].

Since its recognition as an effective tool to identify Schistosoma haematobium infection, haematuria detection has been used in several large scale control programs. However, large variations in performance between age groups, gender, prevalence and areas were observed. Correlation between the degree of haematuria and the intensity of infection and between intensity of infection with age and/or gender could partly explained these variations. Other factors, such as the circadian cycles and day-to-day variations of haematuria and egg excretion, a concomitant presence of blood in urine for another reason than schistosomiasis and the intrinsic characteristics of the reagents strips also contribute to the observed variations. This study assessed the influence of age, gender and intensity of infection taken together on the performance of the diagnostic test by fitting logistic regression models. During a socio-economic study of schistosomiasis, carried out between 1989 and 1991 in a rice-growing area located in Mali, West Africa, haematuria was detected by reagent strips among 2,873 six-year-old and more subjects randomly chosen from 14 villages. The "gold standard" of infection was provided by the parasite egg counts. Laboratory quality controls were implemented. Observed sensitivities, specificities, positive and negative predictive values were calculated by the standard two-by-two tables. The influence of age, gender, intensity of infection, measured in a continuous scale, on these parameters were studied by fitting two logistic models. The first one modelled sensitivity and specificity The second one modelled predictive values. Goodness-of-fit tests were performed. Large variations in the observed values of sensitivities, specificities and predictive values by age and gender were observed. The best fitted model for sensitivity and specificity included infection status, age, gender, intensity and an age by gender interaction. For the predictive values, the best model included haematuria, age, and an haematuria by age interaction. Given the large variations in the performances across the covariates strata defined by cross-tabulation of the age/gender and intensity categories, this modelling approach provided a more realistic appraisal of the performances than using overall values obtained from a general two- by-two table. It allowed to assess the effect of the covariates of interest on the performances of the test and provided an adjustment of the performances on these covariates. The best fitted model was able to provide estimates of sensitivity for each age/gender stratum as a function of the intensity of infection, which could not be done by using the two-by-two table approach. A decrease in sensitivity adjusted for intensity of infection above 10 years of age among males is discussed. This modelling approach also uses all the information available and not only the data from the stratum of interest.

Adolescent↗
PubMed1984

Measurement of urinary leukocyte esterase activity: a screening test for urinary tract infections.

We evaluated the efficacy of testing for the presence of esterase (an enzyme released only from leukocytes) in the urine as an indicator of the presence of pyuria. We hypothesized that a "dipstick" test for urinary leukocyte esterase activity would be a rapid and simple screening technique for detecting urinary tract infections (UTI). To test our hypothesis we collected fresh urine specimens from 203 patients (148 outpatients, 55 inpatients) with a suspected UTI. Each specimen was divided into three aliquots; one was used for reagent strip testing (for leukocyte esterase, nitrite, and blood), one for microscopy, and one for culture. Of the 203 specimens, 49 showed significant bacteriuria (greater than or equal to 10(5) organisms/mL). The leukocyte esterase test was 100% sensitive (0% false negatives) with a 76% specificity (24% false positives) in predicting significant bacteriuria. Although a positive nitrite reaction was more specific (99% specificity, 0.6% false positives), it was insensitive (27% sensitivity, 73% false negatives). The high sensitivity of reagent strip leukocyte esterase testing for pyuria makes it a valuable screening test that should lead to the elimination of many needless urine cultures and microscopic examinations.

Adult↗
PubMedDate not supplied

Evaluation of a programme for control of schistosoma haematobium infection in Yemen.

An intervention study was conducted in Khamir, north of Sana'a, for control of urinary schistosomiasis using chemotherapy and health education. The validity and cost-effectiveness of reagent strips as a rapid diagnostic tool to screen for Schistosoma haematobium infection was also assessed along with visible haematuria. Prevalence of S. haematobium infection 14 months post-intervention fell from 58.9% to 5.8% and frequency of heavy infection from 40.0% to 18.9%. Health education sessions resulted in significant decrease in the frequency of contact with water sources and greater adherence to preventive measures. Mass chemotherapy plus health education is a feasible and effective method for reducing S. haematobium infection in Yemen. Reagent strips and visible haematuria could be cost-effective in remote areas with limited access to health services.

Adolescent↗
PubMed1997

Control of Schistosoma haematobium morbidity on Pemba Island: validity and efficiency of indirect screening tests.

Four indirect screening methods for the detection of Schistosoma haematobium morbidity are compared (history of haematuria, visual haematuria, and microhaematuria at the 1+ and 2+ positivity limit by reagent strips) in terms of their diagnostic performance under conditions of progressive decrease in prevalence of infection, intensity and risk of morbidity as a result of repeated schistosomiasis control programmes on Pemba Island, United Republic of Tanzania. The results show that the sensitivity of a history of haematuria was higher (71%) in children but lower in adults (40%), similar to the findings for visual haematuria in children (60%) and adults (40%) at baseline. However, visual haematuria had a higher specificity, positive predictive value, and efficiency than a history of haematuria in both children and adults. Microhaematuria at the 1+ positivity limit (by reagent strips) had the highest sensitivity of all the methods investigated, but the lowest specificity, positive predictive value, and efficiency. Quantitatively, the indirect methods tended to increase in specificity, negative predictive value, and efficiency during the course of the intervention programme. In contrast, positive predictive value tended to decrease, while the sensitivity remained fairly stable. Overall, these findings suggest that a history of haematuria and/or visual haematuria are appropriate methods for preliminary screening of communities to identify those at risk of morbidity. Thereafter, microhaematuria (1+ positivity limit) may be the more appropriate method for targeting intervention at the individual level.

Adult↗
PubMedDate not supplied

[Cost-effectiveness analysis of self-monitoring of blood glucose in type 2 diabetics].

OBJECTIVE: Compare the cost-effectiveness of self-monitoring of blood glucose (MBG) with your non-use. DESIGN: Descriptive and retrospective study covering the period 1995-97 in the 597 type-2 diabetes patients: 286 practicing MBG on a stable basis and 311 not doing so. All are registered in seven health districts in the territorial ambit of Tortosa Primary Care. Were quantified the direct costs in relation to consumption of reagent strips for the practice of MBG, outpatients visits in your primary care center, derivations to specialist of reference and complementary test according to recommendations of the European NIDDM Policy Group in the population user of MBG and no-user; the annual cost increment, the average annual cost and the total annual cost in the population user of MBG and in the application of a ideal model of quantitative and qualitative cover according to clinical recommendations of the Gedaps; and the cost-effectiveness. RESULTS: While the 78% of the total diabetic population satisfy some clinical indication for prescribing MBG, only the 42.5% practice the MBG. The consumption of reagent strips rising of 8% to 15% of the global cost of the diabetic population. In the application of the ideal model of cover, this cost increase up the 30% of global cost. The effectiveness obtained, an 27%, not are significantly different in the population user of MBG and no user. The cost-effectiveness in the user of MBG increased of 210.789 ptes/year to 213.148 ptes/year; and no-user of 162.019 ptes/year to 162.051 ptes/year. The application of ideal model of cover and the gain of an effectiveness near to possible level of efficiency imply an descent average of cost-effectiveness of approximately 60%: 78.904 ptes/year in user MBG and 54.682 ptes/year in no-user. CONCLUSIONS: 1. We choose in the presents conditions the option of no-user MBG. 2. The average cost-effectiveness per diabetic patient will increase by the needs of accommodate the therapy to new standards of metabolic control. 3. Are clear opportunity for the improve the management and to motivate an efficient use of technology associate to defects of public sanitary market. 4. The model of ideal cover associated to greater effectiveness are necessary for to unify the economic and clinic efficiency.

Aged↗
PubMed1987

Quantitative determination of phenobarbital and phenytoin by dry-phase apoenzyme reactivation immunoassay system (ARIS).

We assessed the performance of the apoenzyme reactivation immunoassay system (ARIS) reagent strip tests for determination of phenobarbital (PB) and phenytoin (PHT) with the Seralyzer reflectance photometer. In the assay, the drug of the sample competes with a flavine adenine dinucleotide (FAD)-drug conjugate for binding to a specific antibody; the unbound conjugate then activates apoglucose oxidase to reconstitute glucose oxidase, whose activity is kinetically monitored by a coupled chromogenic reaction. Within-run coefficients of variation (CVs) were less than or equal to 5.0% for PB and less than or equal to 5.6% for PHT; between-run CVs were less than or equal to 6.1% for PB and less than or equal to 6.5% for PHT. Mean analytical recoveries were 100.3% for PB and 100.2% for PHT. Test results were not significantly affected by bilirubin (5 mg/dL), hemoglobin (25 mg/dL), triglycerides (500 mg/dL), uric acid (15 mg/dL), or elevated levels of other antiepileptic drugs. Reagent strip tests correlated very well with substrate-labeled fluorescent immunoassay (r = 0.9923 and 0.9944 for PB and PHT, respectively), enzyme multiplied immunoassay technique (r = 0.9941 and 0.9919), and gas-liquid chromatography (r = 0.9980 and 0.9960). These homogeneous competitive colorimetric immunoassays are particularly suitable for emergency use, for testing small batches of samples, wherever prompt results are needed.

Apoenzymes↗
PubMed2002

Utility of a peritoneal dialysis leukocyte test strip in the diagnosis of peritonitis.

Expeditious diagnosis of peritonitis remains a significant goal in the management of patients maintained on peritoneal dialysis. Several attempts to use leukocyte esterase reagent strips to diagnose peritonitis have been described. In this study we examined the usefulness of a new reagent strip, the PeriScreen Test Strip, in the diagnosis of peritonitis. A series of 72 peritoneal effluent samples obtained from 22 maintenance peritoneal dialysis patients is reported. In this study, the test strips had a sensitivity of 100% and a specificity of 98.3% as compared to an abnormal leukocyte count. Thus, in the diagnosis of peritonitis we believe that the PeriScreen Test Strip can be used as a simple bedside screening test to exclude peritonitis in peritoneal dialysis patients.

Adult↗
PubMed1985

Leukocyte esterase activity and nitrite test as a rapid screen for significant bacteriuria.

The results of a simple, inexpensive reagent strip test for the detection of leukocyte esterase and nitrite in 252 urine specimens were compared with semiquantitative urine cultures. Negative reagent strip results predicted correctly all urine culture results with less than 10(5) CFU/mL. Screening of urine specimens with the Chemstrip L/N could aid in reducing the cost of laboratory testing.

Bacteriuria↗
PubMed1985

Effect of praziquantel on hematuria and proteinuria in urinary schistosomiasis.

In five settlements on Lake Volta, Ghana, 230 persons infected with S. haematobium were treated with either 30 or 40 mg/kg of praziquantel. Both treatment regimes gave similar overall cure rates (60%) and reduction in geometric mean egg counts (92%) at a six-month follow-up. In this highly endemic area, 32% of the initial urine specimens were visibly bloody and only 4% remained bloody after treatment. Geometric mean egg counts of visibly bloody urine specimens were two to six times higher than normal appearing urine specimens. In children under 15 years of age, gross hematuria was reduced by 91% and hematuria as detected by reagent strips was reduced by 77% after treatment with praziquantel. Among adults, gross hematuria was reduced by 76% and hematuria as detected by reagent strips was reduced by 68%. Reduction was observed in 74% of all persons with 100 mg of protein/100 ml of urine or more prior to treatment. The cure rate with praziquantel was only 36.1% in children who had visibly bloody urine specimens associated with high geometric mean egg counts prior to treatment. The lowest cure rate (15.4%) was observed in persons with persistent hematuria and proteinuria after treatment although the geometric mean urinary egg count was reduced 84%. In infected individuals without hematuria or proteinuria prior to treatment, the cure rate was 96%. This study demonstrated that praziquantel reduced clinical signs due to S. haematobium infection as well as achieved a high cure rate and/or reduction of egg excretion. Conversely, individuals with clinical signs of hematuria and proteinuria had a lower cure rate with praziquantel than individuals without clinical signs.

Adolescent↗
PubMedDate not supplied

False positive dipstick for urinary blood in childhood.

BACKGROUND: In view of the obvious practical advantages, the most common test for hematuria is currently a reagent strip. METHODS: A standardized microscopic examination of the sediment was performed in 20 asymptomatic children referred for evaluation of chronic isolated microhematuria detected by means of a reagent strip. RESULTS: In 6 of the 20 children the microscopic examination failed to confirm the result of the dipstick test. CONCLUSIONS: Confirmation for the presence of hematuria by microscopy is the most important step in children with a positive dipstick for urinary blood.

Adolescent↗